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To: Karly Greene From: Lesley Tinker on behalf of the WHI Nutrition/Energy Balance Scientific Interest Group Date: February 16, 2012 Regarding: Poster submission for the WHI Investigators meeting May 3-4, 2012 Enclosed, please find a poster submission for the annual WHI Investigators meeting May 3-4 in Washington DC. The poster is submitted by the WHI Nutrition/Energy Balance Scientific Interest Group. The presenter is: Lesley Tinker WHI CCC Phone: 206.667.6894 Fax: 206.667.4142 Email: [email protected] Thank you. Dietary patterns and the potential for health and disease association studies in WHI Lesley Tinker, Cynthia Thomson, Linda Van Horn, Yunsheng Ma, Rashad Belin, and Marian Neuhouser for the WHI Nutrition/Energy Balance Scientific Interest Group Background: The Healthy Eating Index, Alternate Healthy Eating Index, WHI Dietary Modification Index and other scorebased indices provide approaches to assess dietary patterns, dietary quality, associations with disease risk, and assessment of United States Dietary Guidelines. The WHI FFQ data have been updated recently to support computation of these dietary indices. Objectives/Methods: 1. To give an overview of the My Pyramid Equivalents Database 2.0 and components (MPEDs) recently incorporated into the WHI FFQ dataset. The MPEDs are the building blocks of many dietary pattern scoring systems and are based on dietary assessment data from the National Health and Nutrition Examination Survey (NHANES) nutrition component, What We Eat in America. The 900 WHI FFQ components were mapped to one of the 7,752 MPEDs foods, thus providing greater detail than was previously possible by dividing WHI FFQ line items into food groups. Within the MPEDs, there are 7 major food groups and 32 subgroups: Grain Group: Total grains; whole grains; non-whole/refined grains Vegetable Group: Total vegetables; dark-green vegetables; orange vegetables; white potatoes; other starchy vegetables; tomatoes; other vegetables. Fruit Group: Total fruits; citrus fruits, melons, and berries; other fruits Milk Group: Total milk; milk; yogurt; cheese Meat and Beans Group: Meat, poultry, fish; meat; organ meats; frankfurters, etc.; poultry; fish and shellfish high in n-3; fish and shellfish low in n-3; eggs; beans and peas; soybean products; nuts and seeds Oils: Discretionary oil Extras: Discretionary solid fat; added sugars; alcoholic beverages 2. To give examples of dietary patterns and how to analyze them using WHI data. a) Healthy Eating Index (HEI) – a dietary quality scoring system developed by the USDA for assessing achievement of the USDA Dietary Guidelines for Americans 2005. The HEI is formed primarily from the MPEDs and from individual nutrient data. The HEI for the WHI FFQ is available upon request for approved WHI paper proposals. b) Alternative Healthy Eating Index (AHEI) – a dietary pattern developed for assessing dietary patterns associated with lower risk of chronic disease, including CVD (fatal or nonfatal myocardial infarction, fatal or non-fatal stroke, sudden death), cancers (excluding non-melanoma skin cancer), and noninjury, non-suicide deaths. The AHEI uses MPEDs and individual nutrient data and is being included in WHI manuscripts, e.g., MS 1368 (Yunsheng Ma, convener). AHEI MPEDs are available upon request and through the WHI investigator website for approved WHI paper proposals. c) WHI Dietary Modification Index (WHI-DMI) – a novel WHI dietary index developed by Rashad Belin and colleagues (MS 685) to assess cardiovascular disease risk in association with the WHI Dietary Modification Trial low-fat dietary pattern plus nutrients associate with cardiovascular disease risk. 3. To discuss with conference attendees additional dietary patterns of interest, e.g., Mediterranean Diet Score, Ratio of Ingested Saturated Fat and Cholesterol to Calories (RISCC), Low Carbohydrate Diet Score, Dietary Alternatives to Stop Hypertension (DASH) Diet, and the potential of assessing the current USDA consumer guideline, MyPlate. Results: Specific WHI manuscripts will be presented as examples. Benefits and limitations of the WHI data will be presented. For dietary patterns that include intake of energy, protein, or protein density, use of biomarker calibrated intakes will be discussed. Interpretation: Conference attendees will have the opportunity to learn how to utilize the WHI dietary and nutrient data for health and disease association studies. The benefits of having dietary pattern analyses for the WHI FFQ include (1) comparing WHI diet-health/disease outcomes to other epidemiologic studies, (2) comparing WHI dietary patterns to national recommendations (3) targeting potential diet/food-related interventions.